Getting Past the Myths: The Truth About Working – The Details

Myth #3: If I Work, I Will Lose My Health Care Benefits

Losing your health care benefits can be a huge concern if you are thinking about work. However, there are several programs that can help you keep your health care benefits when you go to work. Some jobs will offer employer-sponsored health care benefits. But for some people that will not be enough. Some people may also want to keep their Medicare or Medical Assistance (MA) benefits. The information below will explain several different options for health care benefits.

Medical Assistance (MA)

Keeping MA is a big concern for people with disabilities who want to work.

Eligibility for MA is based on your income and, depending on your situation, on your assets. There are a couple of common ways you may qualify:

If you are under 65 years old, don't get Medicare, and your family's income is at or below 138% of the Federal Poverty Guidelines (FPG) ($16,753 per year if you are single; $34,638 for a family of four). There's no asset limit if you meet these rules. This way to qualify for Medical Assistance (MA) is explained in DB101's MA article.

If you have a disability or are 65 or older and your countable income is at or below 100% of FPG, which is $12,140 for a single person. Your assets must also be less than $3,000 if you're single ($6,000 for a family of two). Note: Countable income is not the same as total income. See DB101's MA for People with Disabilities article to learn more about how MA counts your income.

If you work and your income is low enough, you should be able to qualify in these ways for Medical Assistance (MA). But $16,753 per year or less is not a lot of money to live on and $3,000 is probably not enough money in the bank to meet your needs. And what if you want to save money to buy a car or a house or go on vacation? There are several other ways you can keep your Medical Assistance (MA) while working and earning and saving more.

SSI’s 1619(b) Program

If you are working, you can continue to get Medical Assistance (MA) coverage even if your earnings are too high to get an SSI cash payment. If you are on 1619(b), you can earn up to $53,658 annually and keep your MA coverage without having to pay a spenddown. You need to be sure and keep your assets under SSI's asset limit as well: $2,000 for an individual, $3,000 for a couple.

Medical Assistance for Employed Persons with Disabilities (MA-EPD)

MA-EPD is another great program for Minnesotans with disabilities. The MA-EPD program lets working people with disabilities qualify for MA coverage no matter what their income is. To be on MA-EPD, you have to pay a premium and keep your assets under the $20,000 asset limit. The premium is based on your income and the size of your household.

For more information, read DB101's MA-EPD section. To see if you might qualify for the program and what your premium would be, use DB101's MA-EPD Estimator.

Employer-Sponsored Health Care Benefits

If you’re working, you can enroll in your company’s employer-sponsored health care plan and still keep your 1619(b) coverage, Medicare, or MA-EPD. In fact, if the employer-sponsored plan requires you to pay for a share of the cost, the state may pay for some or all of that for you (if they figure out that it is cost effective for them to have you covered under both health care plans).

Medicare

If you continue to receive your SSDI when you work, your eligibility for Medicare simply continues. You can also keep your Medicare even if earnings cause your SSDI check to stop, as long as Social Security still considers you disabled. If your SSDI stops due to work, you can keep your Medicare coverage for at least 7 years and 9 months from the end of your Trial Work Period. After that, if you still have a disability and would like to keep Medicare, you can maintain it by paying a monthly Part A premium.

If your income goes up so much that you no longer qualify for MA and you can't get Medicare or employer-sponsored coverage, you may be able to get MinnesotaCare or the government may help you pay for a private health coverage plan on MNsure through tax credits.

You may qualify for MinnesotaCare if your family's income is at or below 200% of FPG ($24,280 for an individual; $50,200 for a family of four). You may get government help paying for private coverage if your family’s income is at or below 400% of FPG ($48,560 for an individual; $100,400 for a family of four). You can check your eligibility for both on MNsure.

Note: If your earnings are over this limit and you have high medical expenses, you might still qualify for 1619(b). Ask your local Social Security office about the 1619(b) Individualized Earnings Threshold.

A trained professional who can help you understand disability benefit programs and how they are affected by work. Their goal is to help you avoid financial complications while developing a sustainable plan for the future.

Documented expenses for services or items that are related to a serious medical condition or impairment and needed in order to work. Wheelchairs, physician visits, copayments for prescriptions, and other medical expenses are some examples of IRWEs. The expenses must be verified by original receipts and canceled checks and approved by Social Security.